Provider Demographics
NPI:1982722658
Name:SVENDSEN, CAMERON S (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:S
Last Name:SVENDSEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19409 N 75TH DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6078
Mailing Address - Country:US
Mailing Address - Phone:623-974-0357
Mailing Address - Fax:
Practice Address - Street 1:10559 N 99TH AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-5413
Practice Address - Country:US
Practice Address - Phone:623-974-0357
Practice Address - Fax:623-974-0399
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW115201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical